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Association between fluoroquinolone exposure and children's growth and development: A multisite biomonitoring-based
Lixin Shan1, Ming Gao2, Xiaohua Pan3
1College of Marine Life Sciences, Ocean University of China, Qingdao, 266003, China.
Insights
Veterinary antibiotic exposure, specifically enrofloxacin, is linked to increased overweight and obesity risk in children. This study highlights the need for careful fluoroquinolone use and disposal to protect child health.
Area of Science:
- Environmental Health
- Pediatric Health
- Toxicology
Background:
- Limited human data exists on veterinary antibiotic exposure's impact on child development.
- Animal studies suggest early-life antibiotic exposure increases adiposity.
Purpose of the Study:
- To measure fluoroquinolone body burden in northern Chinese children.
- To assess the association between antibiotic exposure and children's growth and development.
Main Methods:
- Urinary fluoroquinolone concentrations (fleroxacin, ofloxacin, norfloxacin, ciprofloxacin, enrofloxacin) were measured in 233 children (0-15 years).
- Children's growth was categorized using body mass index Z scores.
- Health risks were estimated using hazard quotient (HQ) and hazard index (HI).
- Logistic regression analyzed the association between antibiotic levels and growth outcomes.
Main Results:
- Four fluoroquinolones were detected in 57.08% of samples, with varying concentrations by region.
- Ciprofloxacin exposure posed potential health risks (HQ > 1 in 20.61% of participants).
- Hazard index exceeded 1 in 23.18% of samples.
- Middle-concentration enrofloxacin exposure was associated with a 3.01-fold increased risk of overweight or obesity.
Conclusions:
- This is the first study linking enrofloxacin exposure to increased overweight/obesity risk in children.
- Increased attention to fluoroquinolone usage and disposal is crucial for safeguarding children's health.
Background:
Although animal experiments found that antibiotic exposure during early life increased adiposity, limited human epidemiological evidence is available for the effects of veterinary antibiotic exposure on children's growth and development.
Objective:
This study was conducted to examine the body burden of fluoroquinolones in northern Chinese children and assess its association with growth and development.
Methods:
After recruiting 233 children aged 0-15 years from 12 different sites in northern China in 2020, we measured urinary concentrations of 5 respective fluoroquinolones (fleroxacin, ofloxacin, norfloxacin, ciprofloxacin, and enrofloxacin) by high performance liquid chromatography. Categories of children's growth and development were identified based on the Z score of body mass index. The health risks of individual and combined antibiotic exposure were estimated by the hazard quotient (HQ) and hazard index (HI), respectively. The association between children's growth and development with antibiotic concentrations was evaluated via multiple logistic regression analysis.
Results:
In total, 4 antibiotics, fleroxacin, ofloxacin, ciprofloxacin, and enrofloxacin, were found in urine samples of northern Chinese children at an overall frequency of 57.08%. Due to diet and economic differences, antibiotic concentrations in urine samples differed by study area, and the highest concentrations were found in Tianjin, Henan, and Beijing. The percentage of the participants with HQ > 1 caused by ciprofloxacin exposure was 20.61%, and the HI values in 23.18% of samples exceeded 1, suggesting potential health risks. The odds ratio (95% confidence interval) of overweight or obesity risk of tertile 2 of enrofloxacin was 3.01 (1.12, 8.11), indicating an increase in overweight or obesity risk for children with middle-concentration enrofloxacin exposure.
Conclusion:
This is the first study to show a positive association of enrofloxacin internal exposure with overweight or obesity risk in children, demonstrating that more attention should be given to the usage and disposal of fluoroquinolones to safeguard children's health.
